A low anterior resection does NOT remove the entire rectum and sigmoid unless a new pouch is constructed (it is possible and not uncommon in cancer cases to create a j-pouch using colon instead of small bowel). The fact is that quality of life is extremely low if there is no pouch, either the "original" pouch, the rectum, or a neopouch like a j-pouch (or a colostomy or ileostomy, for that matter). In the early 80s when j-pouches for UC were very new, some "lucky" patients received straight connections of the ileum to the anus, with no pouch created, under the hypothesis that the ileum would expand over time to become a pouch on its own. This did not happen, and those patients required revision surgery or permanent ileostomy.
dx'ed UC pancolitis 5/12
past meds: asacol hd, VSL#3, apriso, rowasa, xifaxan, 6mp, cortifoam, pentasa, cimzia, canasa, butyrate, flagyl, cipro, prednisone, remicade, methotrexate, cholestyramine, cortenema
current meds: none!
step one: colectomy, end ileo 1/16/13
step two: j-pouch construction, loop ileo 5/1/13
step three: takedown 7/31/13